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ADVANCE Perspective: Physical Therapy & Rehab Medicine

CSM 2012 Preview: Making an Impact

Published January 19, 2012 2:48 PM by Lisa Lombardo
With the official kick-in of the Health Care and Education Affordability Reconciliation Act of 2010 looming in 2014, now more than ever physical therapists have to find their place at the table for health policy decisions on a national level.

The APTA recognizes the urgency for the profession to become a key part of health care reform decisions. This year's Combined Sections Meeting in Chicago next month will feature a two-part session

"Physical Therapists Impacting Health Policy Through Health Services Research: A Survival Strategy for Health Care Reform," held on Thursday, February 9.

A panel of expert speakers in PT education, research and evidence-based practice include Daniel Pinto, PT, DPT, OCS, FAAOMPT, Peter McMenamin, PT, MS, OCS, Anthony Delitto, PT, PhD, FAPTA, Justin Moore, PT, DPT, Marc Goldstein, EdD, and Janet Freburger, PT, PhD. They will describe how current APTA initiatives and strategies relate to areas of research within the context of health care reform. Part 1 will review the profession's health policy initiatives and address ways to impact policy, including effectiveness of services research and economic evaluation methods. In Part 2, therapists currently engaged in health services research will talk about their work and discuss future directions for physical therapy.

The goal of the discussion is to identify areas of physical therapy health policy and practice that need a health services research focus, and to gather suggestions for promoting and advancing physical therapy through participating in research and advocacy.

Bringing physical therapy to the forefront of health care reform decisions was emphasized recently by Zoher Kapasi, DPT, associate professor and interim director of the Division of Physical Therapy, Emory University, in "Health Reform Law and its Impact on Physical Therapists: Value Across the Spectrum of Care," published in December 2010 in The Academic Exchange.

"To assist Congress with difficult decisions relating to spending in health care, the health care reform law authorizes an independent body called the independent payment advisory board (IPAB) to make policy recommendations that would limit spending within Medicare. This independent body will assist Medicare with its fiscal challenge of an aging population, a decline in the number of workers per beneficiary, and increasing life expectancy," says Dr. Kapasi. He mentions some important aspects of health care reform as it relates to physical therapy:

Cost savings in the long term. "The impact on physical therapy could be positive if the IPAB looks at the potential cost savings of physical therapy interventions compared to surgery or other more costly interventions. The impact could be negative if the IPAB simply focuses on increasing use of physical therapy services without looking at the larger cost savings that can result from physical therapy in lieu of more expensive interventions," he said.

Involvement in evaluations and assessments. "As the federal government moves forward with developing a bundling payment model, physical therapists will provide critical decision-making on the best setting for care after the patient's acute care hospital stay. In addition, physical therapists will play an essential role in ensuring reduction of hospital admissions because physical therapists assess the overall picture of the patient with their physical performance. Of critical importance will be the participation of physical therapists on technical expert panels and other advisory groups as assessment tools and quality measures are being developed.

Prevention as a critical component. "The new health reform law takes an aggressive approach to prevention. Seen as one of the key elements of reform, lawmakers hope that key investments in preventive services and delivery models will help lower overall health care spending and improve health indicators for more Americans. The APTA estimates that over time these provisions will be positive for consumers and physical therapists. Physical therapists who focus on prevention and wellness promotion may experience new opportunities. The incentives provided in health reform will likely encourage further investment in this area."

Do you think APTA is doing an overall good job in lobbying the profession to be decision-makers in health care reform policy? What other areas of health care reform do you feel APTA should lobby?


I think if we are to have more of a say about how therapy services can decrease costs, we need to have more research to support what we say, from early mobility in acute care to OP patient education prior to surgery, and on.  The more we back up our statements, the more credibility we have.

Rick, P.T. - Director of Rehab January 26, 2012 9:25 AM

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